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Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution or solicitation. PPT Interim 1015
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Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Jan 17, 2016

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Page 1: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Interim CoverageShort-Term Medical

Brought to you by:

Anthem and The IHC Group

© IHC Group 2015

For training purposes only. Not for public distribution or solicitation. PPT Interim 1015

Page 2: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

The Partnership

Anthem and The IHC Group have partnered together to offer short-term limited duration medical expense for your clients, designed to help consumers obtain medical expense coverage between open enrollment periods. This is accomplished by building two plans under separate short-term medical (STM) product series: Interim Coverage and Interim Coverage 2.0.

Partners: Producers, Anthem, Designated Agent Company and The IHC Group

Designated Agent Company is a General Agency owned by Anthem

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 3: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

The IHC Group Corporate Overview

Standard Security Life Insurance Company of New York (SSL) is the underwriting carrier for Interim Coverage, rated A- by A.M. Best

Ebix Health Administration Exchange, a member of The IHC Group, administers Interim Coverage and Interim Coverage 2.0

New York Stock Exchange traded company (NYSE:IHC)

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 4: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Interim & Interim 2.0Coverage Overview

While plans are very similar between the series, benefit options may vary by state.

These plans are not intended to qualify as Minimal Essential Coverage required by the ACA.

Premium may be lower than ACA plans but contains a pre-existing provision and additional limitations.

Interim Coverage and Interim Coverage 2.0 are underwritten. Issuance is not guaranteed.

All plans are non-network plans and exclude outpatient Rx coverage.

If a consumer chooses to utilize the MultiPlan (http://www.multiplan.com/search/search-2.cfm?originator=84453)

Or ACS (www.anci-care.com) networks they may have lower costs due to accessing discounts from contracted providers.

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 5: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Interim Coverage Differences

For training purposes only. Not for public distribution or solicitation.

Interim Coverage Association membership in Communicating For America, Inc. (CA) is

required.

Communicating for America, Inc. is a nonprofit association that has been providing members valued benefits and savings since 1972. The IHC Group short term limited duration medical expense coverage (STM) for which you are applying is a group association plan available to individuals and families. Communicating for America, Inc. (CA) is the master group policyholder. In order to qualify for the short term medical expense insurance, you must be a member of CA. Therefore, your application for IHC Group STM is also application for membership in CA. Your membership will remain in effect as long as you qualify under membership guidelines and pay membership dues, which are charged with the IHC Group STM premiums for your convenience.

The association benefits available through CA are offered at the sole discretion of CA and coverage may vary by availability, vendor and state of residence.

Cost of the association is included in the monthly retail rate.

Interim Coverage 2.0 No association membership required.

Policy is issued directly to consumer.

Coverage offered is based on the resident state of the consumer.

© IHC Group 2015

PPT Interim 1015

Page 6: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Coverage Benefits Interim Coverage

For training purposes only. Not for public distribution or solicitation.

Office visit copay*The number of copays available is determined by the selected plan duration

$50 copay per visit1 copay for 30–90 days of coverage2 copays for 91–180 days of coverage3 copays for 181–3641 days of coverage 1Subject to state specific regulation

DeductibleFamily deductible is 3x the individual deductible

$1,000 $2,500 $5,000

Coinsurance percentage

Out-of-pocket• Does not include the plan

deductible, precertification penalties or expenses not covered

20% 30%* 50%

$1,000 $2,000 $3,000* $4,000*

$1,500 $3,000 $4,500* $6,000*

$2,500 $5,000 $7,500* $10,000*

Maximum Benefit per policy period

$2 million *Benefits not available in CA.

© IHC Group 2015

PPT Interim 1015

Page 7: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Coverage Benefits Interim Coverage 2.0

Office visit copayThe number of copays available is determined by the selected plan duration

$50 copay per visit1 copay for 30–90 days of coverage2 copays for 91–180 days of coverage3 copays for 181–3641 days of coverage 1Subject to state specific regulation

DeductibleFamily deductible is 3x the individual deductible

$1,000 $2,500 $5,000 $10,000

Coinsurance percentage

Out-of-pocket• Does not include the plan

deductible, precertification penalties or expenses not covered

20% 30% 50%

$1,000 $2,000 $3,000 $4,000

$1,500 $3,000 $4,500 $6,000

$2,500 $5,000 $7,500 $10,000

Maximum Benefit per policy period

$2 millionFor training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 8: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

State Availability Map

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 9: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Coverage Eligibility

Primary insured up to age 65

A spouse between the ages of 18-65

Dependent children under the age of 26

Child-only plans are available for children ages 2-18

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 10: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Coverage Duration

Coverage can be purchased in durations between 30 - 180 days and up to 364 days in some states.

Monthly and single pay options are available. If purchasing for a specific number of days (e.g. 57 days) single pay is the only option.

Coverage may be rewritten in most states – rules and policies vary by state. If a policy is rewritten, new pre-existing condition limitations and deductibles/out-of-pocket will apply.

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 11: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Getting Started

You must be contracted with The IHC Group and Anthem in order to sell Interim Coverage and Interim Coverage 2.0.

Contracting is available from your Anthem representative or at the Anthem Coverage Resource Center www.healthedeals.com/ccc-ic

You must have an active Health license in each state that you do business and be appointed by the carrier.

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 12: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Your Personalized Link

Once contracted, you will receive a unique link to quote and enroll your clients.

Bookmark your link for easy continued access

This personalized link will ensure that you receive credit for your sales; do not share with other producers to sell from.

Publish and access your link with the “Link Creation Tool” at any time.

Post your link on your website

Place a banner in your email signature

Email to a client so they can self-enroll

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 13: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Quoting and Enrollment

www.myihcgroup.com

Enroll and assist customers online

Email proposals with application links for clients to self enroll

Only allows you to quote plans that are available in your state

View brochures

View product information

Access your activity reports

Case status

View policy information

Download policy informationFor training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 14: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Enrollment Continued

E-signatures are acceptable

You can complete the application including the medical questions on behalf of the client or allow them to complete themselves

At the end of the enrollment process the client will be asked to review the application for accuracy

All policy documents and fulfillment are provided via email

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 15: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Expenses not Covered (partial listing) Pre-existing conditions

Five-year look back period on pre-existing conditions and includes receiving medical advice, care, diagnosis, treatment, consultation or medication or if there are symptoms that would have caused a reasonable person to seek diagnosis, care or treatment. (look-back period varies by state).

Outpatient prescription drugs Inpatient may be considered covered charges

Pregnancy or childbirth except for the complications of pregnancy Expenses for the treatment of mental illness or nervous disorders,

alcoholism or drug addiction or chemical dependency Expenses paid under workers compensation insurance or automobile

insurance Expenses resulting from participation in interscholastic or collegiate

sports Claims arising from participation in school or organized competitive

sports or any high-risk sport, including riding an all-terrain vehicle, snowmobile or go-cart are not covered

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 16: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Underwriting GuidelinesIneligible for Coverage if:

Eligible for Medicare or Medicaid

Applicant or any immediate family member whether or not applying for coverage that is pregnant, an expectant parent, in the process of adopting a child or undergoing fertility treatment.

Over 300 pounds (male) or 250 pounds (female) or undergone weight loss or bariatric surgery

Been diagnosed or treated for Acquired Immune Deficiency Syndrome (AIDS) or other Immune Disorders

Within the last 5 years (depending on state) if an applicant or any person applying for coverage received any medical or surgical advice, consultation or treatment, including medication for:

Stem cell transplant Heart disorder, heart attack, coronary artery disease or circulatory system disorder (includes by-

pass or stent surgery or carotid artery disease/surgery Stroke, seizures disorder or other neurological disorder Cancer or tumor OR taking medication to prevent recurrence of cancer or tumorous growth Paraplegia, quadriplegia or multiple sclerosis Emphysema, chronic bronchitis or COPD (chronic obstructive pulmonary disease) Insulin dependent diabetes Kidney disorder other than stones and/or liver disease Degenerative arthritis (degenerative disc disease, herniated disc, rheumatoid or psoriatic arthritis

or degenerative joint disease) Alcohol or drug abuse or dependency OR chemical dependency

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 17: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Important Information

THIS IS A SHORT-TERM HEALTH BENEFIT PLAN THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD. THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.

About Communicating for America, Inc. Communicating for America, Inc. (CA) is a national non-profit advocacy organization that supports affordable healthcare for all Americans. Since 1972, more than 100,000 consumers have trusted CA to help them find affordable health insurance and GAP plans to stretch their healthcare dollar while advocating on their behalf with insurance companies, regulators and lawmakers. 

About Standard Security Life Insurance Company of New York Standard Security Life was founded in 1958 is domiciled in the State of New York and is headquartered in New York City. It is licensed in all 50 states, the District of Columbia, the Virgin Islands, and Puerto Rico. Standard Security Life provides various lines of life, health and disability insurance, including: employer medical stop-loss, disability benefit law (DBL), short-term medical, group major medical, individual and group dental and vision, individual accident and health insurance, group term life, specialty programs designed for volunteer emergency service personnel including group life insurance and service awards programs. Standard Security Life is rated A- (Excellent) by A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations (an A++ rating from A.M. Best is its highest rating).

About Ebix Health Administration Exchange Ebix Health Administration Exchange is a full service administrative services company that operates in 50 jurisdictions in the individual and employer markets, and provides state of the art and highly efficient open health insurance exchanges through its affiliation with Ebix Incorporated, and, through an affiliate, is the provider of pet insurance solutions that provide pet parents, specialty pet hospitals and universities and general veterinary practices with the only open exchange in the country for all interested constituencies.

About The IHC Group The IHC Group is an organization of insurance carriers and marketing and administrative affiliates that has been providing life, health, disability, medical stop-loss and specialty insurance solutions to groups and individuals for over 30 years. Members of The IHC Group include Independence Holding Company (NYSE:IHC), American Independence Corp. (NASDAQ: AMIC), Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company. Each insurance carrier in The IHC Group has a financial strength rating of A- (Excellent) from A.M. Best Company, Inc., a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet policyholder obligations. (An A++ rating from A.M. Best is its highest rating.) Collectively, the companies in The IHC Group provide insurance coverage to more than one million individuals and groups. For more information about The IHC Group, visit www.ihcgroup.com.

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015

Page 18: Interim Coverage Short-Term Medical Brought to you by: Anthem and The IHC Group © IHC Group 2015 For training purposes only. Not for public distribution.

Thank you

Questions? Please reach out to your Anthem representative, call 855-632-9003 or email [email protected]

For training purposes only. Not for public distribution or solicitation.

© IHC Group 2015

PPT Interim 1015